{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "SIKORSKY CHIROPRACTIC CLINIC SC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1425 N MCLEAN BLVD",
"SecondLineMailingAddress": "SUITE 700",
"MailingAddressCityName": "ELGIN",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60123-5723",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "104 TYLER CREEK PLZ",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ELGIN",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60123-1784",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "847-695-0464",
"PracticeLocationAddressFaxNumber": "847-695-0461",
"EnumerationDate": "12/04/2006",
"LastUpdateDate": "03/16/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SIKORSKY",
"AuthorizedOfficialFirstName": "STEPHEN",
"AuthorizedOfficialMiddleName": "A.",
"AuthorizedOfficialTitle": "DOCTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "847-695-0464",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}